Showing papers in "Revue D Epidemiologie Et De Sante Publique in 1983"

The effect of death certification and coding practices on observed differences in respiratory disease mortality in 8 E.E.C. countries.

Abstract: National differences in respiratory disease mortality have been observed in eight member countries of the European Economic Community (E.E.C.). To investigate the extent to which death certification and coding practices explain such differences, a representative sample of certifying doctors in each country was asked to complete specimen death certificates for a bank of ten written case histories. The certificates from each country were coded firstly by their own offices and subsequently by the W.H.O. Reference Centre in the U.K. Large within- and between-country differences in the coded causes of death were found. Some of these differences were due to variations in the ways doctors certify deaths, others to the way certificates are coded in each country. These discrepancies explain part of the between-country differences in mortality in some disease categories. Comparisons of mortality statistics for respiratory diseases between different countries should therefore be viewed with caution. There is a need for further standardisation of death certification and coding practices in the E.E.C.

[Mycobacterium kansasii: drinking water contaminant of a hospital].

Abstract: Contamination of tap water by Mycobacterium kansasii in an hospital is described This contamination was responsible for an increased frequency of M kansasii isolates from gastric washings The hygiene measures taken to eliminate the mycobacteria from the water distribution system in the hospital are reported

Drug utilization studies and epidemiology.

Abstract: Drug utilization studies have developed rapidly over the last ten years to become not only a new tool of investigation for clinical pharmacology but also a source of suggestive information for epidemiology. This paper begins by reviewing the general terms of reference, with special emphasis on the WHO-recommended methodology based on defined daily doses (D.D.D.), then focuses on antidiabetic treatment, and antihypertensive therapy, and on the use of drugs in psychiatry, in pregnancy, in elderly people and in cancer patients. These examples are given to show how drug utilization studies can be of use for epidemiological studies.

Breastfeeding in the industrialized world. Review of the literature.

Abstract: Since the Industrial Revolution there has been an almost continuous decline in breastfeeding in North-America and western Europe. But the last years numerous studies report that breastfeeding is regaining popularity. The social forces responsible for this are a back-to-nature movement, ecological concerns, breastfeeding support groups and a renewed interest by scientists, the health profession and national and international organizations. Many determinants of child feeding behaviour have been analyzed extensively: ethnic and cultural background, socioeconomic and employment status, maternal (age, parity, marital status) and child (sex, birthweight) characteristics, maternal knowledge and attitudes, health care management. Still the relative influence of these factors can only be estimated, partly because of a lack of an accurate methodology. The reasons mentioned with regard to weaning often indicate a lack of confidence intensified by deficiencies in information and support systems. The negative influence of the infant food industry on breastfeeding behaviour cannot be disregarded. Clearly the promotion of breastfeeding in our society is a policy matter, requiring positive action in the field of health education; legislation, research and the reorganization of health services.

L'administration de diéthylstilbœstrol (DES) pendant la grossesse, un problème de santé publique

Abstract: The analysis of the health risks associated with the administration of diethylstilbestrol (DES) during pregnancy (for the prevention or treatment of threatened abortions) has been largely published. Concerning mothers, a relationship between DES exposure during pregnancy and risk of cancer is unproved. However, existing studies are sufficient cause for serious concern over drug's carcinogenic potential, and further follow-up studies are required. Concerning daughters, a clear association between in utero exposure to DES and clear cell adenocarcinoma of the vagina or cervix is established (incidence between 0.14 and 1.4 per 1000 through age 24). The risk for squamous cell cancer of the vagina and cervix does not seem to be increased. Cervico-vaginal adenosis is frequent (20% to 60% of exposed subjects). This is not a pre-cancerous lesion, its spontaneous evolution is towards regression. No treatment is prescribed. Morphological changes of the genital tract have been described, their consequences on fertility and pregnancy are not clear. Concerning sons, an excess of genital abnormalities (especially of the epididymis and undescended testis) has been reported, but information on the fertility implications of these findings is not available. There is no evidence of an increased risk of testicular cancer. The analysis of all these informations should allow to bring up a policy to take into account these risks in the population.

Nitrates in the drinking water and cancer mortality. An epidemiologic study in northern France

Abstract: This epidemiological survey was conducted in the Northern country of France, on 753 communes. Nitrate concentration in drinking water was measured from 1974 to 1976. The mean concentration rates (M.C.R.) calculated for the three years, were under 95 mg/l, and 93% were under 43 mg/l. The association between the M.R.C. and digestive and urinary cancer mortality rates observed in the same area (1968-1975) was studied, using different statistical techniques. No systematic relationship was observed taking into account the site of the tumor and the age and the sex of the subjects. The role of other variables is considered in the discussion: duration of exposure, use of other beverages such alcohol or mineral water. The duration of exposure, use of other beverages such alcohol or mineral water. The authors conclude that drinking water does not seem to play a determinant role in the causation of cancer; relationship, if it exists, it remains to be demonstrated.

Alcohol consumption patterns in the department of Calvados (France)

Abstract: The individual consumption of alcoholic beverages was determined by interviewing 1976 people, a representative sample of the population 92% of males and 74% of females drink alcohol but no more than 4% of females consume over 40 g per day, against 39% males The average intake is greater in rural than in urban areas Wine is the most popular beverage but the consumption of cider remains important in rural areas Apple brandy is also consumed in sizeable quantities by rural males There are few beer drinkers, except in the younger age groups The implications of these results are discussed They probably reflect changes in drinking patterns over time; the traditional locally produced cider and apple brandy are progressively abandoned by the young, who turn to beer and aperitifs Consequent changes in alcohol related pathology are expected

[Mortality by socio-occupational categories in urban and rural areas].

Abstract: Mortality data in France are studied by a cross sectional analysis including both population density (urban or rural aggregates) and socio-economic groups. The socio-economic differentials in mortality increase with the size of localities. Specific social class distribution partly explains the excess of mortality in rural areas and the lowest mortality in the parisian agglomeration. On the contrary social class distribution does not affect mortality in small towns. Nevertheless, the expected effect of social class does not explain all the discrepancies in mortality between urban and rural areas. The population density is a parameter that should be taken into account when analyzing mortality.

Can arboviruses from seabird colonies in Brittany infect man

Abstract: Four tick-borne arboviruses circulate heavily and permanently among the seabirds colonies located along the coasts of Brittany: Soldado, Zaliv Terpeniya, Avalon and a member of Tyuleniy subgroup of flaviviruses. In order to appreciate the ability of these viruses to infect man, the authors studied for antibodies the sera of farmers living in South-Finistere, in the vicinity of Cape Sizun seabirds reserve. Antibodies were actually found on 14 of 474 farmers, or 3.0 per cent, substantiating the reality of infection by these agents. The possible mechanisms of the contamination and the eventual pathologic results of these viral infections are discussed.

[Retirement, psychological well-being and health: longitudinal study of a population of Parisian executives].

Abstract: A longitudinal study was carried out on a sample of 155 french male managers in order to test the hypothesis that retirement has negative effects on health and life satisfaction in upper white-collar workers. At wave 1 (in 1976) of the study, these 155 managers were all working full time. At wave 2 (in 1979), 105 were retired and 50 were still working full time. Results from the comparison of these two groups do not support this hypothesis. On the other hand, the data suggest that some psychological factors assessed at wave 1 are, independently of retirement, significantly related to changes occurred in health and life satisfaction between the two waves of the study.

[Enterovirus circulation in the waste waters of the Lorraine region. Evaluation of a survey 1976-1981].

Abstract: A survey of the presence of viruses in wastewater has been conducted during 6 years in 19 treatment plants of the lorraine area The results presented in this paper show the presence of numerous viral species in the 1938 samples analyzed from 1976 to 1981 and large variations of the annual positivity rate linked to the circulation of enteric viruses in the population By direct inoculation to cell cultures the search of virus is positive in only 15% of the samples On the other hand a previous concentration step allows to obtain an increase of positive samples Taking into account the important aptitudes of polio and non poliovirus to survive in water, the survey of wastewater could be a good indicator of their presence in the population The isolation of non vaccinal polioviruses confirm the need of the continuation of the vaccination program, but perhaps also a reevaluation of the rule of the living oral vaccine because of the presence of so called "intermediary strains"

[Cross-sectional study of growth between 3 and 20 years of age in the population of Tunisia].

Abstract: In the course of a study designed to estimate the prevalence of diabetes in the Gouvernorat of Tunis, 1449 households chosen at random were examined at home between October 1976 and June 1977 The following parameters : weight, height, tricipital and subscapular skinfold thickness were determined for each subject 3 years old or more From the data observed on 1 889 males and 1 940 females aged from 3 to 20 years, estimates by age and sex are proposed as references for growth among the tunisian population in urban area Then an approach of the secular trend is derived from the distributions of height according to the year of birth in the adult population

[Effect of socio-occupational category on iterative hemodialysis treatment of advanced chronic renal insufficiency. Results of the DIAPHANE computerized Dialysis Registry cooperative program].

Abstract: The hypothesis that inequalities may be observed between patients of different socio-professional categories (S.P.C.) was assessed in a group of 1267 men treated by chronic haemodialysis (C.H.) in 34 dialysis centers throughout France and followed up in the computerized DIAPHANE Dialysis Registry. The percentages of manual workers and farmers were found lower than those calculated on the whole active french population. In contrast, the percentages of senior executives and patient with liberal professions were higher. Primary renal disease was detected sooner in patient of the higher S.P.C. than in other groups. Patients of the higher S.P.C. were more frequently treated in university or in private hospitals than in general hospitals. They were more likely on evening or night dialysis schedules than on daylight schedules; they more frequently received hypotensive drugs, vitamin D, calcium, iron, prescriptions of blood transfusions than patients of the lower categories. Survival rates were not correlated with the S.P.C., but the rehabilitation rate, expressed as the percentage of part or full time employments, was greater in patients of the higher S.P.C. Results indicate that, in patients treated by chronic haemodialysis, inequalities in favor of the patients of the higher socio-economic categories are observed and that these inequalities concern both the access and the delivery of care.

Epizootic swine influenza on animal farms in Brittany

Abstract: Since 1976, seroepidemiological surveys using radial haemolysis and isolation trials from samples collected from pigs at the abattoir showed that Brittany was an important reservoir of swine subclinical infections due to the human Influenza A viruses H3N2. Influenza A H1Sw N1Sw subclinical infections sporadically occurred from 1979 to 1981. In January 1982 an epizootic started in Finistere which spread from west to east. The H1Sw and N1Sw antigens of 28 stains isolated from 1979 to 1982 were studied with ferret and rabbit anti sera and appeared to be variants of the previous strains (1976-1967-1961-1930). A reinforced serological survey in pigs demonstrated that both Influenza A viruses H1Sw N1Sw and H3N2 simultaneously spread in herds. There is no actual prove of recent human infections by A H1Sw N1Sw virus.

[Effect of atmospheric pollution (SO2--dust) and meteorological conditions on mortality in Paris between 1969 and 1976].

Abstract: The short-term effect of environmental factors (atmospheric pollutants, meteorology) on mortality are studied with 8 years of continuous daily data collected in Paris (1969-1976). Mortality data are specified using daily-rate of death, according to diagnosis and age-range. Chosen pollutants are acidity and smoke. Meteorological conditions are identified by synoptic data and local parameters (pressure, temperature, humidity). Relations between mortality and pollution, and their interaction with meteorological conditions, have been described with several statistical methods. Among results, it is shown for example that relation of pollution levels with total daily deaths is not very clear but it becomes very significant for very old population; the strongest relation occurs for deaths connected with respiratory diseases, with a maximum 2 or 3 days after, but possibly later. Climatic factors such as synoptic situation and temperature have also influence on mortality but not so significant as pollution.

Descriptive analysis of episodes of atmospheric pollution occurring in Paris between 1969 and 1976 and their consequences on daily mortality

Abstract: Simultaneous evolution of daily data collected in Paris (1969-1976) concerning mortality on the one hand, and pollution and meteorology on the other hand, is described during two specific episodes: the first, observed in december 1969, is a high mortality one, due to an influenza epidemic; the other, observed in december 72-january 73, is related to high pollution levels. Mortality data are specified using daily-rate of death, according to diagnosis and age-range. Chosen pollutants are acidity and smoke. Meteorological conditions are identified by synoptic data and local parameters (pressure, temperature and humidity). Among results, it is shown for example that the mortality-excess is mainly due to respiratory diseases, that it concerns elderly persons when heavy pollution, but younger persons (less than 75 years old) when influenza epidemic; pollution effects are not detected when daily acidity level is less than 300 micrograms/m3 but they systematically appear for level more than 400 micrograms/m3. "Compensation" effects (mortality-rate decrease occurring after high mortality days) have been pointed out. Tentative interpretation is proposed, including also temperature and humidity effects, and validation is necessary to do.

Perinatal mortality in the Grand Duchy of Luxembourg. The trend from 1969 to 1979

Abstract: Results of a survey on perinatal mortality in Luxembourg between 1969 and 1979 are presented. Important differences by geographic region are noted although differences by socioeconomic status maternal age and marital status are no longer significant. The low rates of perinatal mortality among foreigners in Luxembourg are indicative of the success of preventive measures. (summary in ENG) (ANNOTATION)

Politique de prévention des affections méningococciques en Belgique

Abstract: Une recrudescence des affections meningococciques dues principalement a des souches de serogroupe B et du serotype 2 a ete observee entre 1969 et 1975. En l'absence de vaccin efficace, la prophylaxie a ete de prevenir l'apparition des cas secondaires chez les sujets ayant ete en contact avec un malade. La tactique prophylactique optimale est basee sur l'identification des contacts a risque, la surveillance etroite de ces contacts et la prescription d'une chimiotherapie adequate

[Incidence of and indications for cesarean sections in the Quebec, Canada region 1973 and 1979].

Abstract: This study describes the frequency of cesarean sections and their indications in eleven hospitals located in the Quebec City area, in 1973 and 1979. Information on cesarean sections was abstracted from hospital records. Birth certificates provide the information on all deliveries. From 1973 to 1979, the cesarean delivery rate increased from 7.9 to 13.6 per 100 deliveries. Repeat cesarean sections account for 40.4% of this increase, while primary cesarean sections for dystocia, breech presentation and fetal distress explain respectively 21.1%, 21.1% and 12.3% of the rise. Prolonged labour, prolonged rupture of membranes, general anesthesia and pre-term repeat cesarean section were observed less frequently among cesarean sections in 1979. Moreover, Apgar scores were higher in 1979 than in 1973.

Expanded vaccination program. Training model for community medicine

Abstract: The expanded programme on immunization (E.P.I.) is a very concrete example of community health programme. In so far, it uses various methods which the medical personnel should be taught a better way: the epidemiological method, health planning, health management. The E.P.I. provides a great deal of actual conditions well-suited to the preparing of either tutorials or self-training modules within various fields such as epidemiological surveys with estimate or evaluation purposes, planning for a prevention strategy, supply management. Aiming at the enlargement to community health and with a much more participative pedagogical spirit, the author points out the importance of making the educators aware of unequalled capabilities of training provided by the E.P.I.